Review of the lab/vitals file at my facility (a large teaching facility) for this first optional reporting showed that 68% of our qualifying cases were admitted thru the ED.  Of those ED cases, 17% had a length of stay > 24 hrs (range was 1-8 days).  And of the ED cases with missing vitals/labs, 88% did have vitals/labs but they were taken/drawn > 24 hrs before admission. The majority were drawn 25-72 hrs before admission.  We would like to ask for your consideration to extend the # hours before admission for those admitted thru the ED from 24 hrs to 48-72 hours.